Low back pain (LBP) is a condition that many individuals will experience at some point within their lifetime1, and many of these individuals will seek medical attention2-4. As a consequence of this, expenditures associated with LBP have increased significantly over the years5 and will continue to increase if no changes are made. Unfortunately, this statistic may be due to the lack of comprehension regarding treatment interventions and techniques commonly utilized by clinicians, many of which may not be supported by evidence 6. In order for the technique to be safe, effective, and reproducible, the magnitude, velocity, and rate of application of the force must be imparted within relatively narrow limits. Despite the widespread use of manual techniques, the external forces that are actually applied during manual therapy are still being investigated as an assessment of direct forces between the clinician and patient have yet to be documented. Pressure measurement systems by novel have been proven accurate and reliable and been used in previous clinical studies15-19. However all systems currently available on the market measure the normal force as a function of time. No commercially available dynamic pressure measurement system currently quantifies shear forces in conjunction with the normal force. Therefore the development of a 3D force sensor (a sensor that measures the 3 components of force: Fx, Fy, Fz) which can be displayed in real-time must be developed. In the present Phase I proposal, Novel Sensor Technologies Inc will work with their collaborators to develop a 3D force sensor, by accomplishing the following specific aims: Specific Aim 1: To develop and test a single 3D force sensor. Our initial design will be the starting point for Specific Aim 2. A mechanical model will be developed that allows the application of calibrated forces. The performance of the sensor will be tested by bench tests with known forces using a materials testing machine. Specific Aim 2: Develop and test a multi-cell 3D force sensor array. The single sensor described in Specific Aim 1 will be used as the starting point to develop a multi-cell sensing array. The performance of the multi-cell sensor array will be systematically tested as described above. Specific Aim 3: Design of a clinical study for Phase II. Working with the consultants, we will gain knowledge from clinicians on the sensor application and use in a clinical setting. These open forum discussions will be used to continue the development of the sensor and subsequent electronics and software and the clinical study will be designed through collaboration between the clinicians and Novel Sensor Technologies. A long-term goal for the project will be to develop an electronic system hardware and software to scan multiplex circuitry for several sensor matrices in different array formats. Another long-term goal is the implementation of the instrument on a large clinical trial to understand its effect on patient care and outcome measures of manual therapy application. PUBLIC HEALTH RELEVANCE: Low back pain (LBP) is a condition that many individuals will experience at some point within their lifetime1, and many of these individuals will seek medical attention2-4. There is also an associated rising expenditure related to LPB and this may be due to the lack of comprehension regarding treatment interventions and techniques commonly utilized by clinicians. In order for the technique to be safe, effective, and reproducible, the magnitude, velocity, and rate of application of the force must be applied within relatively narrow limits. Therefore, the development of a portable 3D force sensor which provides real-time feedback of the application and direction of load that the clinician applies, could provide a more effective and efficient treatment for the patient and ultimately may decrease the occurrence of pathologies that require manual therapies.